Congestive Heart FailureLeft bundle-branch block is associated with increased 1-year sudden and total mortality rate in 5517 outpatients with congestive heart failure: A report from the Italian network on congestive heart failure*,**,★
Section snippets
Study design, collected data, and definitions
Data for this analysis were originated from the database of the Italian Network CHF Registry,19 a survey designed in 1995 by an ad hoc committee of the Italian Association of Hospital Cardiologists (Florence, Italy). One-hundred fifty cardiologic centers accepted participation in the study. Centers were distributed across the national territory and were more frequently located in Northern (46%) than in Central (24%) or Southern (30%) Italy, well representing the whole country. Short training
Results
The study population of 5517 patients had a mean age of 63 ± 12 years (range, 14 to 96 years) and included 1295 women (23.5%) and 1544 cases (28.0%) that were classified in NYHA class III to IV. The 1076 patients with complete 1-year follow-up data who were excluded from this analysis had a similar age (65 ± 12 years; range, 17 to 91 years) but a larger prevalence of women (38.6%; P <.01) and of NYHA classification III to IV (38.8%; P <.01).
Discussion
The association of a wide QRS with increased mortality rate in CHF has been repeatedly investigated, but results have been conflicting. Although some studies showed that a wide QRS has an independent, unfavorable prognostic significance and increases the mortality rate of patients with CHF during periods of follow-up examination extended to 5 years,11, 12, 14 other studies adopting similar multivariate approaches did not confirm this finding.10, 13, 16 Such discrepancies may arise from the
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The Italian Network on Congestive Heart Failure Registry was supported in part by Merck Sharp & Dohme spa Italy.
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Reprint requests: Aldo P. Maggioni, MD, ANMCO Research Center — Via La Marmora 34, 50121 Florence, Italy.E-mail: [email protected]